MEDICARE: STEVE ELLIOT REIMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	5101011218	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	700H060020	OTHER	MI	BCBSM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205835535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE ELLIOT REIMAN DO

Provider Business Mailing Address
First Line	:	52375 N MAIN ST
Second Line	:
City	:	MATTAWAN
State	:	MI
Zip	:	49071-9332
Country	:	US
Telephone Number	:	269-668-3348
Fax Number	:

Provider Business Practice Location Address
First Line	:	52375 N MAIN ST
Second Line	:
City	:	MATTAWAN
State	:	MI
Zip	:	49071-9332
Country	:	US
Telephone Number	:	269-668-3348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/15/2014

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